Statement by the European Public Health Association (EUPHA) on migration, ethnicity and health

Migrants and ethnic minorities (MEM) often face serious inequities concerning both their state of health and their access to good quality health services. These inequities are increasingly being brought to light by public health researchers, but action to tackle them has lagged behind. To ensure that adequate attention is paid to the determinants of MEM health and the problems of service delivery that can confront these groups, health systems need to become more inclusive. The rising tide of populism and nationalism in European politics has created a hostile environment for such reforms.

Nevertheless, a new willingness to stand up for migrants’ rights is emerging at the level of international organisations. Member organisations such as the IOM, WHO, ILO and UNHCR have succeeded in placing migration centre stage at the United Nations, where ‘Global Compacts’ on migrants and refugees are currently being drafted.1 These are linked to the Sustainable Development Goals (SDGs) that define the UN’s development programme for 2015-2030.

The SDG’s, with their maxim of ‘leaving no-one behind’ and their emphasis on equity in all countries (not just ‘developing’ ones), provide welcome and explicit support for efforts to combat inequities in MEM health.

For those who are unwilling to see research on MEM health limited to a purely academic enterprise, these are encouraging moves. However, policies can only be as good as the data they are based on. EUPHA is therefore issuing this call to reduce the gap between researchers and policy-makers, in particular those responsible for setting research priorities and implementing findings. The statement addresses the following key issues, which are discussed in more detail in the Explanatory Memorandum:2 1.

The need for evidence-based policies on MEM health. How can the evidence base for policy reforms be strengthened? a. Fundamental concepts and data collection The need for more and better data should be the first priority in MEM health. Because of the failure of research funding bodies and health system managers to recognise the importance of a strong evidence base, researchers and service providers alike suffer from a shortage of crucial data.

Progress is also hampered by the lack of harmonisation of fundamental concepts.

1 https://refugeesmigrants.un.org/migration-compact

2 https://bit.ly/2KN66jV

b. MEMs’ state of health and its determinants Epidemiological evidence, based on population-based rather than clinical data, is badly lacking on many topics. On the principle “no smoke without fire”, it is often assumed that migrants’ main health problems are those on which most research has been carried out. However, priorities are often defined by myths rather than realities.

c. Issues concerning service delivery The interaction between health services and their MEM users, including issues of access, quality, utilization and communication, has become a major field of research within EUPHA.

Not enough attention is paid to the need to adapt health services to the needs of migrant and minority users. Quite independently of their particular vulnerabilities, MEMs have the right to affordable and effective health services of all kinds and at all times, not only in emergencies. Considerations of immigration policy should never be allowed to stand between them and the help they need.

2. The target group. Whereas most international organizations tend to confine their attention to migrants, the position of EUPHA has always been that ethnic minorities need to be considered as well. These include the descendants of migrants as well as indigenous minorities. Such groups may experience inequities at least as great as those affecting migrants, and often similar in nature. This has implications for data collection: both ethnicity and migrant status need to be taken into account.

3. The diversity of MEM groups. Over-generalising approaches that fail to acknowledge diversity within groups need to be replaced by ‘intersectional’ analyses that examine simultaneously the effects of socioeconomic position, sex/gender, age and many other variables, as well as their interactions. Instead of being targeted at monolithic categories such as ‘migrants’, ‘refugees’ or ‘minorities’, policies should focus on within-group differences and real need. A ‘grapeshot’ approach encourages stereotyping and inaccurate targeting. Neither migrants, refugees nor ethnic minorities should be labelled in their entirety as ‘vulnerable groups’: to do so is to stigmatise them and underestimate their strength and resilience. In service delivery, ‘diversity sensitivity’ is to be preferred to a narrow emphasis on ‘cultural competence’.

4. The need to return to a broader framing of migration. The influx of unauthorised entrants to the EU in 2015-2016 (the so-called ‘migrant crisis’) has led to a one-sided focus on the needs of forced and irregular migrants – ignoring the ‘routine’3 migration that is in no way a ‘crisis’. Moreover, whereas the response of policy-makers to the 2015-2016 influx focused mainly on asylum seekers and refugees, many of the newcomers have joined the EU’s existing population of migrants in irregular situations; this group is all too often neglected in both research and policy-making. 3 The word ‘routine’ is preferred to ‘regular’, in order to emphasize the fact that asylum seekers, despite often entering without authorisation, regularise themselves by making an asylum application. However, we do not wish to classify asylumseeking as ‘routine’. The distinction ‘forced/unforced’ is also avoided, because research has shown that it is impossible to regard these as mutually exclusive categories.

5. Combating the fragmentation of MEM health policy in Europe. Much duplication of effort and ‘reinventing the wheel’ results from insufficient coordination within and between responsible agencies. In addition to the intrinsic divisions between European countries and language communities, regional and international organisations often compete with each other instead of cooperating, which leads to wasted effort and lost opportunities to create synergies. Priorities should be based on the latest insights into public health and the position of MEM in today’s Europe.

6. More attention in EU research programmes for MEM health. MEM health was a central topic in the First and Second Programmes of the European Commission (EC), but apart from a sudden surge in financing for projects on asylum seekers and refugees, it has been seriously neglected so far in the Third Health Programme. EUPHA is concerned about the lack of attention in this programme for health inequities in general, and those affecting MEMs in particular.

7. Better provision of education and training on MEM health. Although this Statement is primarily concerned with the links between research and policy-making on MEM health, capacity building in both areas has to be supported by education and training directed at health workers of all kinds, researchers, managers and policy makers. This should not only be provided in optional additional courses, but as part of basic curricula.

For more information, please contact Prof Allan Krasnik, president of the EUPHA section on Migrant and ethnic minority health, This email address is being protected from spambots. You need JavaScript enabled to view it., or Dr Dineke Zeegers Paget, EUPHA executive director, This email address is being protected from spambots. You need JavaScript enabled to view it.. The European Public Health Association, or EUPHA in short, is an umbrella organisation for public health associations in Europe.

Our network of national associations of public health represents around 20’000 public health professionals. Our mission is to facilitate and activate a strong voice of the public health network by enhancing visibility of the evidence and by strengthening the capacity of public health professionals. EUPHA contributes to the preservation and improvement of public health in the European region through capacity and knowledge building. We are committed to creating a more inclusive Europe, narrowing all health inequalities among Europeans, by facilitating, activating, and disseminating strong evidence-based voices from the public health community and by strengthening the capacity of public health professionals to achieve evidence-based change.

EUPHA - European Public Health Association E-mail This email address is being protected from spambots. You need JavaScript enabled to view it. Internet www.eupha.org Twitter @EUPHActs

See also:http://www.merhcongress.com/wp-content/uploads/2018/05/EUPHA-statement-on-migrant-and-ethnic-minority-health1.pdf

 

Open meeting on a forming a Global Society at lunchtime on Saturday 19th May 2018

This proposal is for a new Global Society to integrate academic, professional and community work on the following interrelated fields: migration, ethnicity, race and Health. The meeting will offer an opportunity for participants to suggest other ways of achieving the same goal. Rationale The 1st World Congress is fostering an integrated dialogue on issues related to migration, ethnicity (and a focus on indigenous and Roma populations) and race, as they relate to health and health care. A major motivation for this Congress was that they are of central importance in public health and health care, especially in relation to equity and equality with the sense that these fields of study and practice, notwithstanding their differences, have much in common, warranting a global endeavour.

The core idea behind a Global society and this proposal is that greater unity, crossworking, and cross fertilisation of ideas through dialogue would strengthen each field separately and hence also collectively. The high participation and the richness of the contributions at this Congress, despite the sparse representation of some parts of the world (e.g. much of Africa, Russia, East and Southeast Asia and Latin America), provide the impetus for creating a Global Society to nurture and further the dialogue. The question to be considered in this meeting is whether such a Society would add value in the current context where there are numerous organisations working in the field, sometimes in formal collaborations, though these are seldom global or encompassing all the identified fields. There are also serious and important questions about the mode of organisation. To be practical, a new Society would likely need to be a coalition of organisations already working in the fields.

Then the main objective of the new organisation would be to enhance cooperation and dialogue across them. There will be important challenges in relation to funding, sustainability and choices between activities.

Next steps 1.

To discuss this proposal in open session to identify the important questions and gauge the degree of support for it.

2. If there is support, to reflect on the core objectives of the new Society and the mode of its organisation. The primary objective could be to promote a dialogue across the fields identified, hopefully allowing us to speak with a unified voice and influence global policies. One specific action might be to help catalyse future World Congresses of the kind we are currently participating in. Our current Congress was an initiative of the Migrant and Ethnic Health Section of the European Public Health Association and incorporates the seventh European meeting of this section.

This model may well work in the future i.e. identifying similar organisations in other parts of the world that run regional meetings and foster collaborations so their meetings can become , on occasion, global. In parts of the world where such organisations do not already exist our Society might promote their development. The next Congress might possibly be in 4-years’ time (2022), so it is a rare event and not clashing with other major meetings. There may be other objectives e.g. fostering networks, creating an internet presence, setting up a newsletter et cetera. As indicated above, the mode of organisation would likely be to develop a coalition of existing organisations and societies working in the field. To our knowledge, none of these straddle the range of fields represented in our current Congress, and certainly not on a global scale. While this needs to be negotiated, we would hope that the coalition partners of this new Society would help provide the relatively small-scale resources required to initiate the work of the Society for short periods of time e.g. two years. 3. Again, given support, we will need a Committee to oversee the work above. The first task will be to identify and communicate with coalition partners. Small-scale funds will be needed. If there is a surplus from this 1st Congress then that might be used for the new group. If not, we may need some seed funding from another funder. A good starting point might be to approach the sponsors of this current Congress. 4. The composition of the Committee needs to be agreed but given the range of fields identified and the global work of the Society it is likely that 15-20 people will need to serve. It would probably be best if these people represented national, regional and international organisations that are already working in these fields to avoid unnecessary duplication of work and to help build alliances. The composition of the Committee is likely to follow standard approaches as follows: Chairperson Secretary Treasurer Members representing major organisations working in the identified fields e.g. APHA, EUPHA, RWJ Foundation etc. Members representing academic, professional and community (NGO etc.) interests In keeping with the rationale and fields of work the composition of the Committee should reflect the diversity of the populations to be served by the new Society.

In addition to the committee there may be advisory groups.

See : http://www.merhcongress.com/wp-content/uploads/2018/05/FINAL-International-Society-Proposal-26th-April-2018.pdf

 

TEAMHP members are planning an active participation at the upcoming MERH Congress.(read below, also http://www.merhcongress.com/)

TEAMHP's Executive Commitee has been encouraging members from across the continent to come this important gathering as it can be a unique follow-up opportunity after the MH-PIE Foundation event of TEAMHP in October 2017

MERH

The MERH 2018 Congress is hosted by an independent, non-profit making company working under the auspices of The University of Edinburgh, the European Public Health Association and NHS Health Scotland.  We intend to deliver you a memorable, affordable, academic and social programme in one of the most spectacular cities in the world.

The MERH congress will replace the 7th EUPHA Migrant and Ethnic Health Section Conference. 

Congress aims :

  • Improve research, population health and health care for migrants and other discriminated-against populations
  • Bring together policy, social science, clinical, social service and public health perspectives and share and transfer learning within and across countries
  • Examine contemporary problems across the globe and debate suggested solutions
  • Consider health effects of social, environmental and demographic change associated with population migration, and the effects on diseases and their causes
  • Find ways to overcome differences in concepts and terminology so the field can be understood internationally in acceptable language
  • Provide opportunities for people to showcase their work and to meet to share experience and motivations
  • Build networks that will last beyond the Congress itself

TEAMHP representatives have been actively involved in conversations and haave had the opportunity to present ongoing projects  with ENIEC members at the annual meeting this year held in Madrid and San Lorenzo de El Escorial,Spain

Eugenia Canaan, Erika Marek, Arnold Nikolett were TEAMHP members at the event

The event this year was also a host Jairo Nunez Criollo (Second Secretary General of the Ecuadorian Consulate in Mardid),Albin O.Larsson the Project Manager at Tehe Swedish Trade and Invest Council for Spain, Portugal and Portuguese speaking Africa

 

President of Global Cleveland , Mr.Joe Cimperman has proposed the idea of building Sister Cities relationship between Cleveland and Pécs during the Post Paprika event meeting  with Cleveland Hungarian Development Panel's Board members and TEAMHP's representatives at the Union Club.

Currently,Cleveland has a similar relationship with the city of Miskolc in Hungary. Now, given the newer opportunities and promises brought by TEAMHP especially in the area of Circular Innovation and Circular Migration, the sister city relationship can offer strategic possibilities to all of the direct and indirect stakeholders

The Healthcare Leadership and Management Development Institute (HLMDI) as the nominated organizer of the FEAMHP (TEAMHP as of Dec,02,2017) has received the duty of administering and coordinating the transnational activities of the platform as the delegate organization by the grantor the Department of State -USA Embassy in Hungary  the IVLP program

Further to the proposal submitted by  FEAMHP's  "Drafting Committee" and the approval by the majority of the "Core Members of the Founding Group" of the FEAMHP hence-forth the CMFG the name  "FEAMHP" derived from : 'The First European American Migration Health Platform' ,will be renamed to TEAMHP derived from : 'The European American Migration Health Platform' as of December 12,2017

Visit our Events menu where you can find the final program of the foundation event of the First European-American Migration Health Platform. We have already uploaded the short bios of our participating members and practical information for all.

In case you have any further questions contact us through one of the specified channels.

We hope to see you in Pécs shortly.

 

FEAMHP Team